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General NPI Number Information
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NPI Number | 1750708780
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Entity Type | Individual
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Provider Name | MICHAEL ANDREW CUDWORTH M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/27/2014
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 777 E 25TH ST STE 420
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City | HIALEAH
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State | FL
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Zip | 33013-3835
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Country | US
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Telephone | 305-691-0118
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Fax |
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Provider Business Mailing Address
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Address Line | 777 E 25TH ST STE 420
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City | HIALEAH
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State | FL
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Zip | 33013-3835
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Country | US
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Telephone | 312-996-6765
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Fax | 312-355-3722
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 036144792
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 25MA10886700
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME162710
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License Number State | FL
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